Search for the field-induced magnetic instability around the upper critical field of superconductivity in H || c in CeCoIn5

We present nuclear spin-lattice relaxation rate (1/T1) at the Co site and ac-susceptibility results in the normal and superconducting (SC) states of CeCoIn5 for H || c near the SC upper critical field Hc2 above 0.1 K. At 4.2 T, 1/T1 rapidly decreases below the SC transition temperature, consistent with the previous reports. Although the field dependence of 1/T1T at 0.1 K shows a peak at 5.2 T above Hc2, the temperature dependence of 1/T1T at 5.2 T is independent of temperature below 0.2 K, showing a Fermi-liquid behavior. In addition, we found no NMR-spectrum broadening by the appearance of internal fields around Hc2 at 0.1 K. We could not detect any field-induced magnetic instability around Hc2 down to 0.1 K although the remarkable non-Fermi-liquid behavior towards Hc2 was observed in various physical quantities.Comment: 6 pages, 3 figure

Thermal Probe Measurements of Energy Flux onto a Substrate in Inductively Coupled Plasmas

ナノダイナミクス国際シンポジウム 平成22年1月21日(木) 於長崎大学Nagasaki Symposium on Nano-Dynamics 2010 (NSND2010), January 21, 2010, Nagasaki University, Nagasaki, Japan, Invited Lectur

Subcutaneous endoscopically assisted ligation using miniport for the treatment of girls with inguinal hernia

Background This report describes the first miniport method using  subcutaneous endoscopically assisted ligation (SEAL) for the treatment of girls with inguinal hernia. To validate its safety and efficacy, the  authors evaluated their early experiences.Methods Between April 2014 and December 2014, 19 SEALs using miniport were performed on 14 patients at the Fukaya Red-Cross Hospital, Saitama, Japan. Their mean age was 6 years (range, 11–128 months). This technique was performed using two ports (a 5mm port placed using the open technique and an additional 2mm miniport). A 5mm laparoscope was inserted via the umbilicus. The miniport was introduced percutaneously in the inguinal region under laparoscopic guidance and manipulated around the medial or lateral   hemicircumference of the internal ring extraperitoneally to place a purse-string around the internal ring. The hernia sac and patent processus vaginalis were closed at the level of the internal inguinal ring   extraperitoneally with circuit suturing using the 2mm miniport. Only the umbilical fascia was closed with an absorbable suture. No skin sutures were applied. We collected data regarding operative time, complications,and recurrence. Results The mean operative time was 20 ±6 min (unilateral, n =9) or 42± 8 min (bilateral, n= 5). The mean follow-up period was 12.8 ± 2.5 (range, 9–19) months. No intraoperative complications associated with theprocedure occurred and no hernial recurrences have been identified so far.Conclusion SEAL using miniport proved to be a successful operative procedure compared with other  laparoscopic percutaneous extraperitoneal closure procedures and produced excellent cosmetic results. SEAL using miniport for the treatment of girls with inguinal hernias appears to be safe, effective, and reliable.Keywords: inguinal hernia, miniport, SEA

Prevalence and safety of robotic surgery for gastrointestinal malignant tumors in Japan

[Aim] The National Health Insurance system has reimbursed robotic gastrointestinal surgery since April 2018 in Japan. Additionally, strict facility and surgeon standards were established by the government and the academic society. This study aimed to evaluate the prevalence and safety of robotic surgery using a Japanese nationwide web-based database. [Methods] Patients who underwent the following robotic surgeries for malignant tumors in 2018 were included: esophagectomy (RE), total gastrectomy (RTG), distal gastrectomy (RDG), proximal gastrectomy (RPG), low anterior resection (RLAR), and rectal resections other than RLAR (RRR). The number of cases and surgical mortality rates each month were calculated to evaluate the prevalence and safety of robotic procedures. [Results] A total of 3281 patients underwent robotic gastrointestinal surgery. The monthly number of robotic surgeries nearly doubled in April 2018 when they were initially reimbursed by the National Health Insurance system. Operative mortality rates were 0.9%, 0.4%, 0.2%, and 2.8% for RE (n = 330), RTG (n = 239), RDG (n = 1167), and RPG (n = 109), respectively. No mortality was observed in RLAR (n = 1062) or RRR (n = 374). [Conclusion] Robotic surgery for gastrointestinal malignant tumors was safely introduced into daily clinical practice along with rigorous surgeon and facility standards in Japan

Laparoscopic Surgery for Acute Diffuse Peritonitis Due to Gastrointestinal Perforation: A Nationwide Epidemiologic Study Using the National Clinical Database

[Background] Elective laparoscopic surgery is now widely accepted in the treatment of abdominal diseases because of its minimal invasiveness and rapid postoperative recovery. It is also used in the emergency setting for the diagnosis and treatment of acute diffuse peritonitis regardless of the causative disease. However, the value of laparoscopy in acute diffuse peritonitis remains unclear. In this study we aimed to show trends in the use of laparoscopy over time and compare the real-world performance of laparoscopic surgery with that of open surgery for acute diffuse peritonitis due to gastrointestinal perforation. [Methods] We extracted data from the National Clinical Database, a nationwide surgery registration system in Japan, for patients with a diagnosis of acute diffuse peritonitis due to gastroduodenal or colorectal perforation between 2016 and 2019. Trends in the use of laparoscopy over time were identified. Patient characteristics, laboratory findings, surgical findings, and postoperative complications were compared between laparoscopic surgery and open surgery. [Results] Patients in poor condition and those with abnormal laboratory findings tended to undergo open surgery. Anesthesia time and operating time were longer for laparoscopic surgery in patients with gastroduodenal perforation but shorter in those with colorectal perforation. Fewer complications occurred in patients who underwent laparoscopic surgery. The number of institutions where laparoscopic surgery was performed and the proportion of the use of laparoscopy at each institution increased over time. [Conclusion] The use of laparoscopy is becoming common in surgery for acute diffuse peritonitis due to gastrointestinal perforation. This approach may be a useful option for acute diffuse peritonitis

Laparoscopic Splenectomy Using a Low-pressure Pneumoperitoneum for the Treatment of Immune Thrombocytopenic Purpura During Pregnancy : A Case Report

Article信州医学雑誌 62(6):441-446(2014)journal articl

Adjuvant Chemotherapy with Gemcitabine for Resected Biliary Tract Cancer: A Single-Arm Phase 2 Study

Article信州医学雑誌 65(2): 99-111(2017)journal articl

An Initial Case Report of a Laparoscopic Spleen-Preserving Distal Pancreatectomy for a Patent with a Pancreatic Metastasis of Malignant Melanoma

Article信州医学雑誌 63(1):19-24(2015)journal articl

Comparison of short term surgical outcomes of male and female gastrointestinal surgeons in Japan: retrospective cohort study

男女の消化器外科医による手術成績は同等 --女性消化器外科医のさらなる活躍に向けて--. 京都大学プレスリリース. 2022-09-29.Study finds no differences in performance between male and female surgeons. 京都大学プレスリリース. 2022-10-04.[Objective] To compare short term surgical outcomes between male and female gastrointestinal surgeons in Japan. [Design] Retrospective cohort study. [Setting] Data from the Japanese National Clinical Database (includes data on >95% of surgeries performed in Japan) (2013-17) and the Japanese Society of Gastroenterological Surgery. [Participants] Male and female surgeons who performed distal gastrectomy, total gastrectomy, and low anterior resection. [Main outcome measures] Surgical mortality, surgical mortality combined with postoperative complications, pancreatic fistula (distal gastrectomy/total gastrectomy only), and anastomotic leakage (low anterior resection only). The association of surgeons’ gender with surgery related mortality and surgical complications was examined using multivariable logistic regression models adjusted for patient, surgeon, and hospital characteristics. [Results] A total of 149 193 distal gastrectomy surgeries (male surgeons: 140 971 (94.5%); female surgeons: 8222 (5.5%)); 63 417 gastrectomy surgeries (male surgeons: 59 915 (94.5%); female surgeons: 3502 (5.5%)); and 81 593 low anterior resection procedures (male surgeons: 77 864 (95.4%);female surgeons: 3729 (4.6%)) were done. On average, female surgeons had fewer post-registration years, operated on patients at higher risk, and did fewer laparoscopic surgeries than male surgeons. No significant difference was found between male and female surgeons in the adjusted risk for surgical mortality (adjusted odds ratio 0.98 (95% confidence interval 0.74 to 1.29) for distal gastrectomy; 0.83 (0.57 to 1.19) for total gastrectomy; 0.56 (0.30 to 1.05) for low anterior resection), surgical mortality combined with Clavien-Dindo grade ≥3 complications (adjusted odds ratio 1.03 (0.93 to 1.14) for distal gastrectomy; 0.92 (0.81 to 1.05) for total gastrectomy; 1.02 (0.91 to 1.15) for low anterior resection), pancreatic fistula (adjusted odds ratio 1.16 (0.97 to 1.38) for distal gastrectomy; 1.02 (0.84 to 1.23) for total gastrectomy), and anastomotic leakage (adjusted odds ratio 1.04 (0.92 to 1.18) for low anterior resection). [Conclusion] This study found no significant adjusted risk difference in the outcomes of surgeries performed by male versus female gastrointestinal surgeons. Despite disadvantages, female surgeons take on patients at high risk. Greater access to surgical training for female physicians is warranted in Japan